Endoscopic Retrieval of Ingested Button Battery From a Colonic Diverticulum in an Alzheimer's Patient: A Case Report

BACKGROUND Foreign body (FB) ingestion is a common problem in children. In a report of adult FB ingestion, 56% of cases involved individuals with mental illness; the most common foreign bodies were batteries (23%), drug-filled balloons for intervention (17%), razor blades (16%), and others. Standard management of an accidentally swallowed button battery (BB) is radiographic evaluation followed by natural passage through the gastrointestinal tract after traversing the esophagus and stomach. Although cases of BB retention in Meckel's diverticulum have been documented, no reports have described retention in a colonic diverticulum. CASE REPORT An 88-year-old woman with Alzheimer's disease presented with retention of a BB in an ascending colonic diverticulum. Multi-detector computed tomography images showed a radiopaque foreign body near the duodenal bulb. Based on the diagnosis of an ingested BB in the duodenal bulb, emergency upper gastrointestinal endoscopy was performed 2 h after admission. However, an abdominal radiograph obtained after admission showed that the BB had migrated into the right colon. Colonoscopy performed the same day revealed that the BB had entered an ascending colonic diverticulum, from which it was successfully removed. To our knowledge, this is the first reported case of BB retention in a colonic diverticulum. CONCLUSIONS Retention of a BB in the colonic diverticulum, which poses a risk of perforation, should be considered in patients undergoing colonoscopy for suspected foreign body ingestion.